The July 17th, 2013 Health Section of the New York Times ran an extensive piece on scoliosis. I pulled out a small section of the article below – as I thought it contained useful norms and guidelines. Reference the entire article here. We are tremendously excited about the results we are seeing in patients with scoliosis using highly individualized, conservative treatments like Schroth Based Therapy and Postural Restoration, often in conjunction with bracing.
Predicting the Extent of Curvature Progression (in Scoliosis)
In Children and Adolescents. After a mild curve is detected, a more difficult step is required: predicting whether the curve will progress into a more serious condition. Although as many as 3 in every 100 teenagers have a condition serious enough to need at least observation, progression is highly variable and individual.
Doctors cannot rely on any definitive risk factors for curve progression to predict with any certainty which patients will need aggressive treatment. Some evidence suggests the following factors may help determine patients at lower or higher risk:
· Having a greater angle of curvature. For example, at 20 degrees, only about 20% of curves progress. Young people diagnosed with a 30-degree curve, however, have a risk for progression of 60%. With a curve of 50 degrees, the risk is 90%.
· Curvatures caused by congenital scoliosis (spinal problems present at birth). These may progress rapidly.
· Treatment with growth hormone. (Studies are mixed on whether this treatment poses any significant risk, although strict monitoring is still essential in young patients being given growth hormone.)
Curvatures may be less likely to progress in girls whose scoliosis was low in the back and whose spine was out of balance by more than an inch. Height also comes into play. For example, a shorter-than-average girl of 14 with low-back scoliosis of 25 – 35 degrees but whose spine is imbalanced by over an inch would have almost no risk. The same degree of curvature in the chest region of a tall 10-year old girl whose spine was in balance, however, would almost certainly progress.
In Adults. In rare cases, unrecognized or untreated scoliosis in youth may progress into adulthood, with the following curvatures posing low-to-high risk:
· Curvatures under 30 degrees almost never progress.
· Predicting progression at curves around 40 degrees is not clear.
· Curvatures over 50 degrees are at great risk for progression.
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
